Physicians writing on KevinMD about the technology in the exam room: the electronic record and what it did to the visit, meaningful use, alert fatigue, pajama time, human and AI scribes and whether they give time back, ambient documentation, telemedicine, and what AI can do in clinical practice now and who is responsible when it is wrong. Two maintained records draw on this archive: The electronic health record: what physicians say, in their own words and Artificial intelligence: what physicians say, in their own words.

Doctors: Bring your practice website to the 21st-century

Health Technology
September 21, 2016

Patients seem to be increasingly comfortable managing their health care through digital media. Last summer, our private practice of eight retinal specialists decided to find out exactly how comfortable.

From July to August, 2015, we conducted a survey of 200 of our patients during their office visit and asked them what health-care related tasks they were already doing online. Using this data, we’re starting to look at how our medical practice might …

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Doctors: Bring your practice website to the 21st-century

Fixing our EHR mess: What needs to be done

Health Technology
September 20, 2016

In 2009 the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law by President Obama and this law quickly changed the way medicine in the United Sates is practiced. The law was a first step in requiring all physicians to utilize electronic records. The president promised that creating and electronic record mandate for physicians would result in a national, universal electronic medical record system and …

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Fixing our EHR mess: What needs to be done

One action that could ease our EHR pain

Health Technology
September 18, 2016

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com.

This September, I reached a milestone, the tenth anniversary of my electronic health record (EHR) “go live.” Note that I did not write “I celebrated my tenth anniversary,” because while the event was the most disruptive change in over 25 years of practice, the word …

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One action that could ease our EHR pain

Pokémon Go shows there is a better way to promote healthy behaviors

Health Technology
September 17, 2016

The recent release of Pokémon Go, the mobile phone augmented reality game, has taken the world by storm. The game has become a fitness icon, requiring players to walk or run around in the real world to catch Pokémon creatures in their virtual world.

While evidence on the long-term health benefits is not clear, it is apparent that the game does more than just allow players to live out their childhood …

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Pokémon Go shows there is a better way to promote healthy behaviors

Should you care which EMR your doctor uses?

Health Technology
September 11, 2016

When you are looking for a physician, what kind of criteria do you use?  Location is probably a priority as is whether or not the physician accepts your insurance.  You might review your state’s medical board, make sure there are no issues with licensure.  Reviewing a physicians medical school and residency training is important.  Some people even like to go in for an appointment just to meet a physician.  As …

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Should you care which EMR your doctor uses?

Will integrated health care startups make health care better?

Health Technology
August 3, 2016

With Obamacare and creation of health insurance exchanges, many believed that health insurers would compete for patients much the same way hotels, rental cars companies, and airlines compete for customers. By comparing identical benefits packages from different insurers, patients could select their insurer based on the monthly premium and the extent of the hospital and physician network.

In a recent Vox article, Ezra Klein urged insurers do “something like …

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Will integrated health care startups make health care better?

It’s time to disrupt basic communications in hospitals. Here’s one idea.

Health Technology
August 1, 2016

I had just taken over three other residents’ phones and pagers when 2-year-old “Bryce” jumped off the couch in our oncology unit, landed on his chin, and bit completely through his lower lip. I quickly reviewed his platelet level from that morning, examined him, and began calling plastic surgery and anesthesia for sutures. While I was on one phone, a second one started ringing. I declined the call and tried …

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It’s time to disrupt basic communications in hospitals. Here’s one idea.

Physician tips to tame your email inbox

Health Technology
July 31, 2016

I am an email junkie and spend more time than I would like to admit on emails every day.  I start my day by looking at emails, and I end every evening reviewing emails.  And yes, I spend time during the day checking the computer for pertinent emails that need my attention.  I think many physicians are of the same ilk.

According to Alexandra Samuels, who is the author of Work …

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Physician tips to tame your email inbox

Nurses identify 10 needs health startups should focus on

Health Technology
July 30, 2016

Startups looking to partner with health systems: This list is for you.

So often, it seems like new technologies being developed for health care don’t address the areas of largest need. We sat down with nursing leaders at the University of California, San Francisco (UCSF) to get a sense of what clinical problems could be best addressed by technology.

The following list was compiled from interviews with Sheila Antrum (president and senior …

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Nurses identify 10 needs health startups should focus on

What J. J. Abrams can teach us about the future of health care

Health Technology
July 15, 2016

As the practice of medicine becomes increasingly digital, our patients are beginning to manage their health from more convenient points of care.  And as telemedicine improves, instantaneous access to health care providers from the comfort of your home or office is now possible. A recent survey of patients in my practice showed that over three-fourths of them have already used or expressed interest in using telemedicine in lieu of a …

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What J. J. Abrams can teach us about the future of health care

Is health IT modern day snake oil?

Health Technology
July 7, 2016

Recently, the American Medical Association CEO called digital health care products modern day “snake oil.”

As a provider and a technologist, I think we need a deeper dive to understand the issues, avoiding the kind of hyperbole that’s so common in politics today.

Paul B. Batalden, MD, Senior Fellow, Institute for Healthcare Improvement (IHI), once said “Every system is perfectly designed to get the results it gets.”

Let’s take …

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Is health IT modern day snake oil?

Why new doctors should think beyond the stethoscope

Health Technology
June 29, 2016

This spring, thousands of medical graduates will cross the stage and become doctors. Yet practicing medicine isn’t the only career for these young professionals; the path to becoming a doctor also provides ample skills for entering the innovation economy.

Today’s medical students are perfectly poised to change the gridlock of the U.S. health care system — and medical schools should empower them with the support and business exposure necessary to tackle …

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Why new doctors should think beyond the stethoscope

Innovative technologies could save millions of lives in the developing world

Health Technology
June 27, 2016

Imagine two babies being born at the exact same time: a little girl in Sweden and a baby boy in Mozambique. What are their chances for a long, healthy life?

In the Scandinavian country of the easily assemblable IKEA furniture and the most secure car in the world, life expectancy in 2015 reached 81.98 years, while in the South African Mozambique with 11.64 billion dollar …

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Innovative technologies could save millions of lives in the developing world

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What went wrong with health care IT

Health Technology
June 24, 2016
YouTube video

One of the topics’s that I’ve written most about, and also do a considerable amount of non-clinical consulting work on, is how we can improve health care information technology and electronic medical records. As they currently exist, there are unfortunately many drawbacks to health care IT systems, and they have as yet failed to fulfill their immense promise.

I’m not a technophobe by any stretch of the imagination. I embrace technologies and …

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What went wrong with health care IT

Where will health IT innovation come from?

Health Technology
June 24, 2016

When my father died three years ago,  my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world.  My father’s life made a difference.

I’m always self-critical and analyzing my own life.  I moved to Boston 20 years ago this month.   In those 20 years of service to Beth Israel Deaconess Medical Center (BIDMC), Harvard, numerous federal organizations, …

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Where will health IT innovation come from?

Insurance companies cannot dictate which medical devices we prescribe

Health Technology
May 27, 2016

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a Medtronic insulin pump instead of offerings from manufacturers like Tandem and Animas.

Many diabetes advocates have eloquently voiced their outrage …

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Insurance companies cannot dictate which medical devices we prescribe

Health IT: The weakest links in a system are actually the people who use it

Health Technology
May 25, 2016

Among the plethora of emails that I receive on a daily basis, there seems to always be at least one sent from my hospital’s information services department. Usually, I receive alerts about system downtime or notifications about resolved tickets. They all have the same general look and feel, and so I hardly ever question that they are official. And then I come across a communication with the message similar to …

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Health IT: The weakest links in a system are actually the people who use it

Here are the limitations of virtual doctor visits

Health Technology
May 21, 2016

Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon.  Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.

One way to think of …

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Here are the limitations of virtual doctor visits

This is what a physician wants in an EMR. Please build it.

Health Technology
April 24, 2016

Adding “electronic” means sortable, searchable, bigger attic, more junk. Unfortunately, no one has the guts to actually clean it. Are urinalyses from the 90s still important, or are we just being sentimental?

For everything we do in medicine, there are intended effects and side effects. During my emergency medicine residency there was a mandate that attending physicians had to see each patient cared for by their residents. While a hard transition, …

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This is what a physician wants in an EMR. Please build it.

If meaningful use is a great idea, why isn’t it employed more widely?

Health Technology
April 20, 2016

A decade ago, electronic health records were aggressively promoted for a number of reasons.  Proponents claimed that they would facilitate the sharing of health information, reduce error rates in health care, increase health care efficiency, and lower costs. Enthusiasts included the technology companies, consultants, and IT specialists who stood to reap substantial financial rewards from a system-wide switch to electronic records.

Even some health professionals shared in the enthusiasm.  Compared to the …

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If meaningful use is a great idea, why isn’t it employed more widely?

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